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General NPI Number Information
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NPI Number | 1073513404
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Entity Type | Individual
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Provider Name | STEPHEN P YOUNG DO
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 425 W GRAND AVE STE. 1003
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7898
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Fax | 937-461-6038
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Provider Business Mailing Address
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Address Line | 425 W GRAND AVE STE. 1003
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7898
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Fax | 937-461-6038
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 34002825
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License Number State | OH
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